Get Well Soon

Helping you to make a speedy recovery after

total hip replacement

Total hip replacement

Contents
Who this leaflet is for 2

What to expect after the operation 3

Things that will help you recover more quickly 5

Returning to work 6

Planning for your return 7

Driving 8

Recovery tracker 9

After you get home 13

Keeping well 16

Website links 17

This leaflet is a guide to recovering from a total hip replacement operation. It does not provide specific medical advice
or diagnosis. Nor does it give advice about whether you should consent to an operation. All of these matters depend
on individual medical advice from your consultant surgeon based on your own health, medical condition and personal
circumstances.
Get Well Soon
Helping you to make a speedy recovery after total hip replacement
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Who this leaflet is for
This leaflet is for anyone who is recovering Obviously, every individual has different
from, or is about to undergo surgery needs and recovers in different ways
to have his or her hip replaced. The so not all the advice in this leaflet will
technical term for your operation is total be suitable for everybody. When youre
hip replacement or total hip arthroplasty, weighing up how to make the decision
which is how your surgeon and other thats right for you, talk to your surgeon,
health professionals who are helping you your GP, or your Occupational Health
may refer to it. service at work, if you have one. They
will all be able to help you make the right
This leaflet should be read in conjunction choises for a safe and speedy recovery.
with any other information you have
already been given about your procedure.
help you make the important decisions
about your recovery. Your surgeon,
general practitioner (GP) and other
healthcare professionals will offer you a
lot of very good advice - but ultimately its
you that has to make the decisions.
This leaflet offers broad guidelines for
people who do not have any complications
with their surgery, or other specific
medical circumstances, such as a long-
term condition.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement
Painkillers
Painkillers may well cause
constipation, so its important
to get plenty of fibre in your
diet while you are recovering.
Fresh fruit and vegetables
will help to keep your bowels
moving regularly.
What to expect after the operation
Scar
You will have a single scar in the region of
your hip and this will measure anywhere
between 8 and 20 cms (3 and 8 inches).
The length of scar is dependent in part
on obesity and musculature. The exact
position of the scar will depend on the
approach that your surgeon uses to enter
the hip joint and can be on the front, side
or back of your hip. The wound can be
closed in a number of ways including
with sutures that need to be removed, or
dissolvable sutures, with staples or with
glue.
Stitches
If you have stitches which need to be
removed, this can usually be done by the
practice nurse at your GP surgery about
10 days after your operation. You should
make an appointment for this as soon
as you get home. Your hospital should
already have given you advice about how
your wounds are closed and how to care
for them.
Dressings
How your wound is closed will influence
whether you need to keep your scar
covered. If your surgeon has used staples
or stitches then the wound should be
kept covered until these are removed. If
your stitches are buried, then the wound
only needs to be covered for the first few
days and you will not have to worry about
getting the scar wet, but follow the advice
given from your surgical team about how
to shower and bathe. If there is leakage
from the wound, you should inform the
surgeon immediately.
Rehabilitation
Once you have left hospital, you may
continue to receive physiotherapy, but
this is not always required. You should
continue the exercises taught to you by
the physiotherapist while in hospital and
follow the advised precautions. The hip
joint will regain mobility of its own accord.
Walking is encouraged and you should
walk as far as is comfortable every day.
Preventing blood clots
Measures to prevent clots in the leg need
to be taken following hip replacement,
normally continuing for about six weeks.
In addition to the exercises advised by
your surgeon and physiotherapist and
early mobilisation, your surgeon is likely
to advise a number of other measures,
dependent on what is best for you. You
may be given an injection of a medicine,
such as Heparin sodium, which used to
prevent blood clots,
Discomfort
You will experience pain and discomfort
around the scars, especially for the first
few days and it is likely that you will
require pain relief on a reducing basis over
the first few weeks.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement

What to expect after the operation

Swelling
Swelling of the leg is very variable and can
be quite troublesome to some patients
for several weeks. Swelling can cause
the leg to ache and indeed make the leg
feel very heavy. To avoid this, sitting for
long periods is discouraged. In between
frequent walks, it is better to be in a
reclining position. Dont worry if the leg
becomes very bruised. This will settle in
due course.
Tiredness
Your body is using energy to heal itself,
so you will feel more tired than normal
- sometimes it can come upon you
suddenly. You will also have lost some
blood during the operation, as well as
into the soft tissues of the leg after the
operation, and it takes a few weeks for the
body to return the blood level to normal.
You may be given an iron supplement to
help this. You should try to eat a healthy,
balanced diet to help ensure your body
has all the nutrients it needs to heal.
Crutches and walking sticks
After your procedure, it may be necessary
for you to use crutches or walking sticks
for a while. Your physiotherapist will
measure you and provide you with a pair
of crutches, and show you how to use
them.
Constipation
It is quite normal that you will not have a
bowel action for the first 2 to 4 days after
the operation. When you go home, its
important to have plenty of fibre in your
diet while you are recovering. In addition,
fresh fruit and vegetables will help to keep
your bowels moving regularly. Drink plenty
of water, but not more than 2 litres a day.

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Get Well Soon
Helping you to make a speedy recovery after total hip replacement
If you live alone, and you do
not have family or friends
close by, organise support
in advance - have family or
friends come to stay with you
for the first few days after
surgery if possible.
Things that will help you recover
more quickly
Eat healthily
Eating a healthy, balanced diet will help to
ensure that your body has all the nutrients
it needs to heal.
Stop smoking
By not smoking - even if its just for
the two weeks before the operation
and the time that youre recovering -
you immediately start to improve your
circulation and your breathing, not to
mention a whole list of other benefits to
the heart and lungs.
Family and friends
Family and friends can give you two
important things:
Practical help with the tasks you might
be temporarily unable to do while
you recover - such as driving, the
weekly shop, or lifting heavier items.
Keeping your spirits up!
Keep a routine
Get up at your normal time in the morning,
get dressed, move about the house;
go out for a walk as soon as you feel
confident enough to do.
Build up gradually
Have a go at doing some of the things
youd normally do, but build up gradually.
Some suggestions are included in the
recovery tracker. Obviously everyone
recovers at a different speed, so not all
of the suggestions will be suitable for
everybody.
When youre building up your activities,
you may feel more tired than normal.
If so, stop, and rest until your strength
returns. If you feel pain, you have probably
just overdone it a little. Ease back on
your activities for a day or two and then
gradually increase them again. If you have
severe pain, consult your GP.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement
You do not need your GPs
permission to go back to
work - this is ultimately your
decision, but listen to the
advice given to you by the
healthcare professionals
looking after you.
Returning to work
Returning to work How soon can I go back?
Although most people who need to have a Every person recovers differently and has
hip replacement are retired, as increasing different needs. In most cases its usually
numbers of people now work beyond safe to return to light work or an office-
the retirement age, its worth mentioning based job within 6 weeks of the operation.
how to balance work and recovery if this If your job involves heavy duties, you
applies to you. may need to be off work for several
more weeks. If your employer has an
Fact: work can be part of your occupational health nurse or doctor they
recovery will advise you on this. Alternatively your
Everyone needs time off to recover after GP can give you advice.
an operation - but too much of it can
stand in the way of you getting back to
normal. In fact, by staying off for too
long, people can become isolated and
depressed. Getting back to your normal
routine sooner rather than later will play a
big part in preventing this.
Getting back to work
How quickly you return to work depends
on a number of things:
How you heal
How you respond to surgery
The type of job you do
People whose work involves a lot of heavy
lifting, or standing up or walking for long
periods of time, will not be able to return
to work as quickly as those
who have office jobs which are less
demanding physically.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement
3 golden rules for a
speedy recovery:
Stay active.
Keep a normal daily routine.
Keep social contact with
people.
Confidence
It will take you a little while
to regain your full confidence
when you go back to work.
You may be slower than
normal at first, so dont take
on too much responsibility
too soon. Dont be too hard
on yourself about this - its
perfectly normal and youll
start to get back up to speed
after a few days.
Planning for your return
Talk to your Occupational Health service If you have an HR Department at work,
or GP to work out when and how is best they will be able to advise you on how your
for you to return to work. absence might affect any benefits you may
be receiving during your time off.
Depending on the nature of your job, you
might want to ask your employer about Depending on the type of work you do,
returning to work on lighter duties at first. people whove had a hip replacement
This means: sometimes find that in the long term, they
need to be redeployed
Spending more time sitting rather into a role which is less strenuous. If
than standing or walking you think this is the case, talk to your
workplace Occupational Health service.
Doing work that is mostly paperwork,
using a computer or telephone
Not carrying more than around
5kg any significant distance
Avoiding tasks such as
prolonged loading or unloading,
packing or unpacking.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement
Ultimately, it is your
responsibility to ensure that
you are in control of the
vehicle at all times and to feel
confident that you would be
able to demonstrate this if
asked.
Driving
Your insurance company should be
informed about your operation. Some
companies will not insure drivers for a
number of weeks after hip surgery, so its
important to check what your policy says.
Normally, driving should be avoided for
the first 6 weeks and even travelling as
a passenger is best avoided for the first
three weeks (except for essential journeys),
as getting in and out of a car can risk
straining the hip and stretching the healing
tissues. However, you should discuss this
with your surgeon.
Before resuming driving, you will need
to be fully recovered from your surgical
procedure. You should be free from the
distracting effect of pain or the sedative or
other effects of any pain relief medication
you may be taking. You should be
comfortable in the driving position and
able to safely control your car, including
freely performing an emergency stop.
If you have an automatic vehicle and it
is your left hip that has been replaced
(assuming a right-hand drive vehicle), you
may be able to drive earlier, but this should
be discussed with your surgeon and would
depend on your general health, medical
condition and personal circumstances,
including the views of your insurer, and
whether you are a Group 1 (car or motor
cycle) or Group 2 (bus or lorry) licence
holder.
Driving - an exercise
After about 6 weeks, you might want
to test your fitness to drive. Do this in
a safe place without putting the keys
in the ignition: simply sit in the driving
seat and practise putting firm pressure
on the pedals. If you feel pain, you are
not yet ready to drive. If you feel sore
afterwards, you may need to wait a day or
two and try again. Only when you can put
enough pressure on the pedals to do an
emergency stop - should you think about
driving again.
It is advisable not to restart driving with a
long journey.
Notifying the Driver Vehicle and
Licensing Agency (DVLA)
After total hip replacement, you do not
need to notify the DVLA unless instructed
to do so by your doctor; however, it is
important to follow your doctors advice
about driving. Higher medical standards
are required for those holding a Class
2 licence, so for reasons of safety and
comfort your doctor may advise you to
delay driving further. You should also
speak with your employer.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement

Recovery tracker

Days/Weeks How you might feel Things you can do safely Traffic light Fit to work?
Post Op

12 days Your hip will be sore from the
operation and you may have pain in
your thigh as well. You will be given
pain relief to keep you comfortable
and this might make you feel quite
drowsy. When mobilising you will
tire easily and you may feel light-
headed.
You will walk with support and No
under the supervision of a
physiotherapist.
You will be given advice as to
what movements to avoid in
order to prevent the new joint
dislocating.

When can I have sex? specific print

instructions:
For many people, being To print only this section of
able to have sex again is the document click once on
an important milestone in the print icon in your Acrobat
their recovery. There are Browser, or go to File, then
no set rules or times about Print on the drop down menu.
when its safe to do so other Then select pages 9 to 12 in
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gradually.

9
Get Well Soon
Helping you to make a speedy recovery after total hip replacement
Recovery tracker
Days/Weeks How you might feel
Post Op
3 days There should be much less pain
in your hip. You should be able to
move a lot more easily than in the
last couple of days, but youll still
get tired more quickly than you did
before the operation.
45 days The hip should now be feeling
much more comfortable, though
you will still feel tired as your body
uses extra energy for healing and
you may still need some pain relief.
Things you can do safely Traffic light Fit to work?
You may well be home by now - No
many hospitals have a recovery
programme of 3 days or less.
If your surgeon allows, you
may well start feeling confident
enough to move from crutches
to sticks.
Y
ou will still need some pain
relief medication but perhaps
be able to give up the stronger
ones.
Walk for 5 10 mins several No, but you
times per day, going for slightly may feel able to
longer walks each day.
do a couple of
hours a day of
administrative work
from home.
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Get Well Soon
Helping you to make a speedy recovery after total hip replacement

Recovery tracker

Days/Weeks How you might feel Things you can do safely Traffic light Fit to work?
Post Op

714 days Youll be feeling much stronger Continue to build up the No, but you
but still get tired quite easily; you duration of walking may feel able to
may still occasionally need to take
do a couple of
a mild painkiller. By the end of the
second week, you should be able
hours a day of
to walk easily with 1 stick, although administrative work
this will depend on what approach from home.
the surgeon has used; for some
patients, you may have to use
crutches for considerably longer.

26 weeks Increase walking distances, Unlikely, but you

swim, static cycling. may be able to
do a couple of
Continued use of a walking
stick.
hours a day of
administrative work
from home.

11
Get Well Soon
Helping you to make a speedy recovery after total hip replacement

Recovery tracker

Days/Weeks Things you can do safely Traffic light Fit to work?

Post Op

68 weeks If you have a desk-job, its usually safe to return to work by now. Yes
However, if you have a job which is physically demanding, you
may need to remain off work for several more weeks. Its worth
talking to your employer about lighter duties you can do without
compromising your new hip. Ask your Occupational Health
department for advice on returning to work and lighter duties. If
you do not have one, ask your GP and surgeon what they would
consider to be a safe amount for you to do.

You should have no difficulty with activities like walking, cycling or

swimming.

You will be able to return to driving a light vehicle and internal and
European flights are now safe as the risk of deep vein thrombosis
is now diminishing.

12 weeks By now, you should have returned to work although if you have a Yes
very heavy labouring job, you may not yet be able to perform all
necessary activities.

You may now return to sports such as golf, tennis, cycling etc.

Long-haul flights are allowed.

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Get Well Soon
Helping you to make a speedy recovery after total hip replacement

After you get home

Day Got up at ... Activities How many What times I Went to bed at Hows your hip feeling?
am (eg walked for ... hours rest I needed to rest: ... pm
minutes) needed?

Keeping a track of what specific print

youve achieved each day
will help you to stay positive
and get back to enjoying your
normal life more quickly.
instructions:
To print only this section of
he document click once on
the print icon in your Acrobat
Browser, or go to File, then
rint on the drop down menu.
Then select page 13 to 15 in
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depending on the printer type.

13
Get Well Soon
Helping you to make a speedy recovery after total hip replacement

After you get home

Day Got up at ... Activities (eg How much rest I Went to bed How have I What do you want to achieve
am walked for ... needed after each: at ... pm been feeling? tomorrow?
minutes) Any pain?

Remember, take a step-by-

step approach to getting
better, and build up your
activities in small stages.
Dont push yourself too far
too fast. If youre concerned
about anything, or if you feel
youre not making progress
fast enough, ask your surgeon
or call your GP.

14
Get Well Soon
Helping you to make a speedy recovery after total hip replacement

After you get home

Day Got up at ... Activities (eg How much rest I Went to bed How have I What do you want to achieve
am walked for ... needed after each: at ... pm been feeling? tomorrow?
minutes) Any pain?

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Get Well Soon
Helping you to make a speedy recovery after total hip replacement

Keeping well
Because of your operation, the chances
are youll be a lot more aware of your body
and how it works.

Right now is a really good time to build on

the knowledge youve gained and make
small changes to your lifestyle which can
prevent you from experiencing certain
health problems in the future. You can do
this by:

Improving your diet - get 5 portions

of fresh fruit and veg per day.

Any exercise the best medical advice

suggests that you should try to do 30
minutes of physical activity a day. In
the early stages of your recovery even
a few short walks each day really will
make a difference to your health.

Quit smoking - NHS Stop Smoking

Services are one of the most
effective ways of to stop for good
and theyre completely free. Your
doctor will be happy to help you.

16
Get Well Soon
Helping you to make a speedy recovery after total hip replacement

Website links
The internets a great thing anything you BoneSmart
want to know is there for you at the click http://bonesmart.org/
of a mouse but, do be careful about the
way you use it when it comes to getting NHS Stop Smoking Service
information about your health. Its hard http://smokefree.nhs.uk/
to know which sites to trust, and none of
them can tell you anything thats specific NHS Choices
to your individual medical needs. http://www.nhs.uk/Pages/Homepage.aspx

If you do want to know more about your Department for Work and Pensions
operation, recovery or return to work, here https://www.gov.uk/government/
is a list of trusted websites that offer safe, organisations/department-for-work-
sensible, useful information: pensions

The Royal College of Surgeons of England GOV.UK

http://www.rcseng.ac.uk/ https://www.gov.uk/

British Orthopaedic Association DVLA - Driver and Vehicle Licensing

http://www.boa.ac.uk/ Agency
https://www.gov.uk/browse/driving/
British Hip Society disability-health-condition
http://www.britishhipsociety.com/
Call 111 for nonemergency medical advice

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